COVID-19 Outbreak: Weekly Global Report for Friday, October 2, 2020

AdvaMed recognizes that its members, particularly those with global government affairs responsibilities, are tracking COVID-19 related developments around the world to assess the public health and economic impacts on their businesses. Knowing that companies are consuming information from a variety of sources, AdvaMed's global team would like to provide members with a weekly snapshot of the key statistics, policy developments and advocacy initiatives underway in our priority markets.  If you have any suggestions, we welcome your feedback.

Global

• Weekly COVID-19 statistics- global cases reached 34.1 million, a 2.1 million increase over the previous week. Deaths around the world passed the 1 million mark. The countries with the most reported cases continue to be the U.S. (7.3 million), India (6.3 million), and Brazil (4.8 million).
• U.S. cases exceeded 7.3 million with deaths increasing to 208,000.
• Staff Contact: Ralph Ives (rives@advamed.org).

China

• Weekly COVID-19 statistics –China’s total COVID cases now stand at 90,555 (an increase of 139 over the previous week) and deaths at 4,739 (an increase of 1 over the previous week).Almost all new cases have been linked to foreign arrivals.
• The Chinese government appears convinced that imported frozen food can carry the virus. This week, the Beijing city government urged companies to halt imports of frozen food from countries that have been severely hit by the pandemic.
• China is currently in the middle of its “Golden Week” holiday (Oct 1-8) to celebrate the anniversary of the PRC’s founding and the mid-Autumn festival. The next few days will be an important test of consumer confidence with consumer spending and domestic tourism expected to shoot up.
• Various indicators suggest September was a good month for China’s economy. Manufacturing output is on par with pre-COVID levels and exports remain resilient compared to earlier this year.
• Anecdotal evidence suggests that hospitals have been gradually resuming elective/regular surgeries and operations appear to be at 80-90% of pre-COVID levels, with this range varying by particular medical condition of the patient and geographical area.
• U.S.-China relations remain strained, with the Commerce Dept recently issuing new export controls against one of China’s largest chip manufacturers, SMIC. The Phase One trade deal remains intact and has emerged as a key area of cooperation. China continues to make record buys of U.S. farm products, most notable soybeans and corn.
• Staff Contact: Kyle Churchman (kchurchman@advamed.org)

India

• Weekly COVID-19 statistics – 6,310,267 total cases, 940,705 active cases/98,678 deaths as compared to 5,730,184 total cases, 966,382 active cases/91,149 deaths last week. India became the second country after the US to register 6 million COVID-19 cases on Sunday, amid signs that the pandemic could finally be slowing down in the country, at least for now.
• The Serum Institute of India said on Tuesday, September 29 that it would get a further $150 million in funding from the Bill & Melinda Gates Foundation and the GAVI vaccines alliance to make an additional 100 million COVID-19 vaccine doses for India and other low- and middle-income countries next year.
• As per the latest report shared by MoHFW on Tuesday, September 29, India has seen a close to 100 percent increase in COVID-19 recoveries in the last month.
• The CSIR-Centre for Cellular and Molecular Biology (CCMB) has launched a study in the hospital environment to assess how long and far the coronavirus can stay in air from an infected person, in a bid to strengthen the safety of health workers.
• The National Pharmaceutical Pricing Authority (NPPA) of India capped the price of Liquid Medical Oxygen and Medical Oxygen cylinders. The pandemic has created increased demand for Medical Oxygen (MO) in the country limiting its availability. The Authority deliberated upon the matter in its extra ordinary meeting held on 25.09.2020 and it was decided to invoke extra-ordinary powers in public interest, under Para 19 of DPCO, 13 and under Section 10(20) (l) of Disaster Management Act, 2005.
• A start-up incubated at the Indian Institute of Science (IISc), Equine Biotech, has developed an indigenous RT-PCR diagnostic kit for accurate and affordable diagnosis of Covid-19. "The biggest advantage of Equine Biotech's 'Global TM diagnostic kit' is that it takes just around one-and-half hours to confirm the presence of SARS-CoV-2 in samples," an IISc release said.
• In research conducted at the National Institute of Virology (NIV), ICMR scientists have flagged the presence of another Chinese virus called 'Cat Que Virus', which has a "potential" to cause disease in India, even as it grapples with the COVID pandemic.
• Government purchases of COVID-related goods over Amazon. (i.e. GeM) increased 48.9 per cent in terms of order value from Rs 345.3 crore in March 2020 after the pandemic broke out to Rs 514.4 crore as on September 28, 2020.
• Union Health Minister Dr Harsh Vardhan on Saturday, September 26 said that over 5 lakh personal protective equipment per day are being produced by the 110 PPE manufacturers in the country. "Now we have 110 PPE manufacturers in India, producing over 5 lakh per day.
• The Government may review inclusion of tocilizumab in its treatment protocol for Covid-19 once again due to difference of opinion within the Indian Council of Medical Research’s national task force on the pandemic.
• The Indian government will review efficacy data from all companies working on vaccines before offering a purchase contract, said an official aware of vaccine distribution discussions on September 28. The government will purchase vaccines at least for essential workers, the official said.
• Staff Contact: Abby Pratt (apratt@advamed.org).

Korea

• South Korea’s numbers were down early this week, but are now back in triple digits, with 113. Late report for Friday indicates this number may be lessening to be below 100. This remains low compared to many other countries. South Korea ranks 78^th in the world in both cases and deaths.
• There are 23,389 total cases, 1,808 active cases, and 415 deaths. Korea is reporting 6 deaths per day but preliminary numbers indicate this is declining.  
• Korea is celebrating a holiday this week, so news items are less than usual.  
• President Moon Jae-in assured the South Korean people Wednesday that his government will succeed in the fight against COVID-19 and safeguard the economy from the fallout of the pandemic.
• Korea plans to boost its support for developing countries as part of Seoul's contribution to the international fight against COVID-19. "The government will expand humanitarian support and official development assistance (ODA) efforts regarding COVID-19 prevention in developing countries," Prime Minister Chung Sye-kyun said in his pre-recorded speech to the virtual meeting of the United Nations' Initiative on Financing for Development in the Era of COVID-19 and Beyond.
• The number of recipients of unemployment benefits in South Korea saw the sharpest increase among people in their 20s this year. According to the Korea Employment Information Service, the number of recipients came to 711,471 in August, up 56.4 percent from 454,630 in December 2019. The first case of the novel coronavirus in Korea was reported in January 2020.
• Some conservative groups are backtracking on their plans to hold mass anti-government rallies in central Seoul on Oct. 3, in the face of coronavirus concerns. Former Gyeonggi Province Gov. Kim Moon-soo and other conservative figures announced that they were calling off the protests scheduled to take place in Gwanghwamun on National Foundation Day and asked other right-wing groups to follow their lead. Instead of street protests, they will hold a car parade of about 200 vehicles.
• The National Assembly of South Korea has selected the chiefs of Google and Netflix’s Korean operations as witnesses at the upcoming audits scheduled for October to ask questions about their business practices. According to the country’s legislative body Thursday, Nancy Mable Walker, who represents Google Korea, will be asked to testify at the Science, ICT, Broadcasting and Communications Committee’s first audit on Oct. 7.
• South Korea maintains its 2-week quarantine for all other incoming international travelers and a requirement for all inbound flights to check passengers' temperatures. Anyone with a temperature over 37.5 degrees Celsius (99.5 Fahrenheit) is denied entry. Korea has not issued any guidance on an exemption that is supposedly available.  Korea has indicated all US inbound travelers will be tested for symptoms prior to being moved to quarantine.
• Korea appears to be moving toward implementation of a proposal that would potentially reduce the price of certain cardiac and peripheral stents. AdvaMed is in touch with members and the medtech association in Korea and has had several discussions with the US Government on this topic. We have sent a letter to the health ministry expressing opposition to the proposal. Please contact Joseph Gatewood (jgatewood@advamed.org) if you have an interest in this matter and are not already engaged.
• Resources: http://ncov.mohw.go.kr/en/. 
• Staff Contact: Joseph Gatewood (jgatewood@advamed.org).

Europe 

There is continued and more aggressive spiking in the case rates across the EU including Central and Western Europe. In Western Europe, cases are spiking worst in the UK and France. Spain and France are showing the highest numbers of new cases, both with significant spikes, with the UK increasing but not spiking as much.  Italy seems to be holding well with fewer new cases than even Germany. However, the Italian Senate was suspended after a number of lawmakers tested positive. Spain leads the EU in cases and the UK leads the EU in deaths, followed by Italy and France. Although not in the EU, Russia's reported numbers on COVID are problematic. Russia remains the COVID hot spot in Europe, now reporting 1,185,231 cases, with just 20,891 reported deaths.  By comparison, Italy, with much fewer (317,409) cases, reports 35,918 deaths. 

• New daily cases, which tend to show which countries are increasing in COVID incidence are as follows:  Spain 9,419 (while this is down from 10,653 per day last week, the day prior Spain reported over 11,000 new cases, so numbers are fluctuating significantly on a daily basis); Italy 2.548 (up from 1,786 last week) Germany 1,923 (up from 681 last week); France 13,970 (up from 13,072 last week); UK 6,914 (up from 6,187 last week); Belgium 1,337 (down from 1,823), Russia 8,945 (up from 6,431 last week).  France. Spain and UK are experiencing the worst spikes in Europe. Italy and Germany remain less problematic.  
• New deaths per day (which tend to lag any increased infection rates) remain low and are as follows:  Spain 182; Italy 24; Germany 10; France 63; UK 59; Belgium 15. Russia is reporting 169 new deaths per day.
• The World Bank has announced plans for a $12bn (£9.3bn) initiative that will allow poor countries to purchase Covid-19 vaccines to treat up to 2 billion people as soon as effective drugs become available.
• In an attempt to ensure that low-income countries are not frozen out by wealthy nations, the World Bank is asking its key rich-nation shareholders to back a scheme that will disburse cash over the next 12 to 18 months.
• The World Health Organization has warned of “alarming rates of transmission” of Covid-19 across Europe and cautioned countries against shortening quarantine periods. The WHO’s regional director for Europe, Hans Kluge, said the number of coronavirus cases in September “should serve as a wake-up call for all of us.” Kluge indicated that ‘although these numbers reflect more comprehensive testing, it also shows alarming rates of transmission across the region.”
• European Union officials have urged member nations to move quickly to slow the latest wave of COVID-19 infections to avoid a repeat of the broad lockdowns that paralyzed the continent’s economy in the spring. EU health commissioner Stella Kyriakides said the most recent risk assessment showed that some countries are reporting more cases now than they did during the earlier peak in Europe.
• The regional government of Madrid, the area of Spain hardest hit by the second wave of the coronavirus, has said it will obey new lockdown restrictions imposed by the central government but plans to appeal against them in court.
• The Czech government announced a state of emergency on Wednesday to contain a second wave of COVID-19 infections, which is threatening hospital capacity and has seen the number of deaths from the illness soar. The Czech Health Ministry indicated that the country is facing daily infection rates that are among the worst in the world and represent a 20x increase.
• The EU prohibition against inbound travelers from the US, Russia and Brazil based on COVID concerns remains in place. Inbound travel is permitted from any of 15 approved countries and the list is updated every two weeks. The EU recommended member states gradually lift the travel restrictions for the following countries: Japan, Canada, Georgia, Australia, New Zealand, Rwanda, South Korea, Thailand, Tunisia and Uruguay.
• The recovery in euro zone manufacturing activity increased significantly last month, but it was largely driven by strength from Germany and rising coronavirus cases across the region may reverse the upturn.
• The European Commission today sent the United Kingdom a letter of formal notice for breaching its obligations under the Withdrawal Agreement. This marks the beginning of a formal infringement process against the United Kingdom. It has one month to reply to today's letter. The EU noted that timely and full implementation of the Withdrawal Agreement, including the Northern Ireland Protocol, is a legal obligation. Some commentators see this step as not being as severe as it would seem and is aimed at restoring balance to achieve a deal in light of the recent UK legislation (see item immediately below).    
• A controversial government Brexit bill that breaches international law, giving the UK power to unilaterally rewrite elements of the withdrawal agreement, has safely passed its final House of Commons hurdle, despite continued serious doubts among a number of Conservative MPs about the plan.
• The chances of Britain leaving the European Union without a trade deal have risen dramatically in the last three months, according to major investment banks, most of which now see the probability of such an outcome at 50% or higher. But all six banks which participated in a Reuters poll in June are more pessimistic, with most citing UK legislation that would breach parts of the withdrawal agreement signed with the EU in January.
• Britain has offered a three-year transition period for European fishing fleets to allow them to prepare for the post-Brexit changes as part of an 11th-hour deal sweetener. The catches of EU fishermen would be “phased down” between 2021 and 2024 to offer time for European coastal communities to adapt to the changes.
• British car manufacturers could face higher export tariffs with or without a Brexit deal after the EU rejected an argument that components from Japan used on UK assembly lines should be considered British. The car industry has maintained that parts for cars, vans and trucks that have been sourced in non-EU countries should be deemed British under the rules of origin system that will apply to all exports from 1 January when the transition period is over.
• People arriving to the UK from Denmark, Slovakia, Iceland and the Caribbean island of Curacao now need to self-isolate for 14 days. Turkey and Poland were added to the list this week.
• The U.K. is at a "critical moment" in the pandemic and "costly" new restrictions on daily life will be introduced if needed, Boris Johnson warned Wednesday. Addressing the British public from Downing Street, the prime minister insisted he did not want to return to a "national lockdown" as he announced that for a second day running the U.K. had recorded more than 7,000 coronavirus infections and 71 deaths — a figure comparable to that seen just before the country went into lockdown in March.
• The latest findings from a UK academic study indicate that infections have increased substantially across all age groups and across all areas of the country.
• ABHI is conducting a comprehensive analysis of the re-start of elective procedures in each Trust and Health Board in the UK. The results can be found here: https://www.abhi.org.uk/membership/members-area/updates/2020/july/the-restart-of-planned-care/.
• In Germany, ventilating rooms has been added to the German government’s formula for tackling coronavirus, in refreshing news for the country’s air hygiene experts who have been calling for it to become official for months.
• Lufthansa says it will test the practice of offering on-the-spot coronavirus tests before boarding intercontinental flights in an attempt to find a way to get long-haul passengers flying again. The airline said it was working with partners in the pharmaceutical industry to obtain an accurate test that could provide results within 15 minutes for 10 euros ($12). The tests on some routes to the U.S. are to begin in October and the practice will depend on government approval. The company said the routes to the U.S. had not been decided yet. “We are in contact with various airports in North America,” the company said in a statement. One option is to make the tests a requirement for everyone boarding that flight.
• The German government said it would pour 750 million euros, equivalent to $891 million, in grants into three local companies developing coronavirus vaccines, bringing Berlin’s total bet on such research to more than €1 billion.
• In France, the prestigious Pasteur Institute confirmed the discovery of a “very promising” drug in the fight against the coronavirus pandemic, without naming it. The unnamed drug has undergone a number of laboratory studies which found that it showed a powerful effect against the virus. The drug is expected to begin clinical trials this winter. Speculation is that this appears to be an existing drug rather than a new compound.
• French authorities could place Paris under maximum COVID alert beginning Monday. The Health Minister said infection rates in the capital and its suburbs are rising and a decision on imposing new restrictions will be made on Sunday. He added that a "total closure of bars" could be needed in the capital. As noted here last week, similar restrictions have already been imposed in Marseille.
• President Macron has said that the EU is “screwed” if the EU Parliament no longer meets in Strasbourg. France is upset over decisions by the Parliament to meet in Brussels rather than travel to Strasbourg for plenary sessions. Macron believes not meeting in Strasbourg will shift EU focus even more to Brussels to the detriment of member states, including France.  
• If you are experiencing difficulties with exporting PPE from the EU, please let us know immediately. We have not seen any instances of this occurring since an initial incident was resolved.
• The proposed one-year suspension of implementation of the EU's MDR is now final.  The measure extends until May 26, 2021 the date of application of the current regulation but does not extend every target deadline referenced in the law.  It also creates the possibility of EU-wide derogations for specific medical devices.
• https://ec.europa.eu/commission/presscorner/detail/en/IP_20_718;
• https://www.medtecheurope.org/news-and-events/press/medtech-europe-welcomes-the-amendment-of-the-medical-devices-regulation-and-urges-similar-action-for-the-ivd-regulation/.
• AdvaMed's joint programs in Germany and the UK continue to provide COVID-19 updates and support on MDR implementation. We recently hosted joint webinars and working group calls with ABHI to give members the latest information.  
• Resources: https://www.ecdc.europa.eu/enlll.
• https://www.europarl.europa.eu/news/en/headlines/priorities/eu-response-to-coronavirus;
• https://www.gov.uk/guidance/coronavirus-covid-19-information-for-the-public;
• https://www.ecdc.europa.eu/en;
• https://ec.europa.eu/info/live-work-travel-eu/health/coronavirus-response/economy_en;
• https://www.abhi.org.uk/what-we-do/abhi-covid-19-hub/;
• https://ec.europa.eu/commission/presscorner/detail/en/IP_20_582;
• https://www.bundesgesundheitsministerium.de/en/press/2020/coronavirus.html;
• https://www.medtecheurope.org/covid-19-information-hub;
• https://www.medtecheurope.org/resource-library/european-industry-trade-and-supply-chain-needs-to-respond-to-covid-19/;
• https://www.medtecheurope.org/wp-content/uploads/2020/03 European_Union_Emergency_Support_Instrument_for_the_healthcare_sector_-_questions_and_answers.pdf;
• https://www.medtecheurope.org/resource-library/eu-materials-covid-19/.
• Med Tech Europe White Paper on Companion Diagnostics under the IVDR:       https://www.medtecheurope.org/resource-library/joint-medtech-europe-efpia-white-paper-on-companion-diagnostics-under-the-ivdr/
• Staff Contact:  Joe Gatewood (jgatewood@advamed.org)

 Latin America

Regional

• Total COVID-19 cases up 5% and deaths up 4% over the previous week.

WEEKLY HIGHLIGHTS –COVID 19

• Argentina: Government extends economic relief measures as COVID-19 cases rise in provinces beyond Buenos Aires.
• Bolivia: 130,000 COVID-19 case-mark signals that the country could be reaching peak levels according to experts.
• Brazil: Local electoral calendar underway.
• Chile: Government announces official agreement to adhere COVAX-facility mechanism.
• Ecuador: President Moreno completely vetoed the new Organic Health Code.
• Mexico: Mexico has formally adhered to COVAX.
• Paraguay: Border reopening with Brazil hits roadblock.
• Peru: The President sent a bill to Congress to expedite the authorization of the application of COVID-19 vaccines.
• Uruguay: Local elections under strict sanitary protocols.
• Staff Contact: Steven Bipes (sbipes@advamed.org)